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SMART-Indivo App Challenge
Webinar Presentation
Tuesday, August 7
On today’s call:
Adam Wong
Management and Program Analyst
ONC
Hemali Thakkar
Manager, Developer Challenge
Health 2.0
Nikolai Schwertner
Lead Software Engineer
SMART
Kenneth Mandl
Director
Boston Children’s Hospital Intelligent
Health Lab
Pascal Pfiffner
Postdoctoral Fellow
SMART
Agenda for Today’s Meeting
ONC and the Investing in Innovation (i2) Program
An Introduction to the SMART-Indivo Challenge
Q&A About the Challenge
ONC and i2
i2 Goals
• Better Health, Better Care, Better Value through Quality Improvement• Further the mission of the Department of Health and Human
Services • Highlight programs, activities, and issues of concern
• Spur Innovation and Highlight Excellence • Motivate, inspire, and lead
• Community building – Development of ecosystem
• Stimulate private sector investment
Indivo and Personal Health Platforms
• Portals:–A static view into the EHR
• PCHRs: –Apps platform, and a patient copy of the data
Ecosystem
SUBSCRIBEThe Verbs of PCHR
New Approaches to Data Liquidity
SHAREThe Verbs of PCHR
VA Survey• 79% of Veterans are willing to share personal health
information with those outside their health system–62% with a spouse or partner–23% with a child–15% with another family member–25% with a non-VA health care provider
ADD AN APPThe Verbs of PCHR
“We cannot overstate how important PHRs are to the efficient functioning of a low-cost, high quality health-care system . . . . We think that the INDIVO system, or something like it is a good place to start.”--Clayton Christensen Harvard Business School
http://commonhealth.wbur.org/2011/07/killed-google-health
• Trust issues
• No app developers• No data
The App Store for Health
ONC Funded Research Project under the
“SHARP” program
We imagine EMRs as an iPhone-like platform where an innovator can create and widely distribute an app
across many disparate EMRs and PHRs
An
Inspired Design
from Dave McCandless
(cc license)
1 Design + 1 Developer + 1 Week
1 Developerin1 Week
EHR as an “iPhone-like” Platform
23
SMARTBP Centiles App
Running on Cerner
ARCHITECTURE OVERVIEW
Apps
Containers
API
Vocabulary
SMART Components
UI Standards-based integration, flexibility
Authentication In-browser, server-to-server
Data Context, Medical Record Elements
Apps need
Container UI
Each container implements a consistentmechanism for delegating access: OAuth.
The app only needs to speak OAuth.
Authentication
SMART data
80/20 approach concentrate on common outpatient data
Consistent coding systems
Medications: RxNorm (SCD, SBD, Packs)Problems: SNOMED CTLabs: LOINC
Extensible representations in RDF
Architecture Summary
SMART Containers supply Apps with UI integration Authenticated API Access Data
Containers shoulder significant responsibility!
Data models are critical to enable app developers Keeping developer experience in mind Data need to be predictable, (relatively) simple
Indivo and SMARTWhat SMART adds to Indivo• Standardized Application Programming Interface
that can run across diverse instances of health information technology
• SMART app developed for an EHR can run unmodified on Indivo. Or, can be tweaked for a patient-facing experience
• The Indivo data model will continue to track the evolution of the SMART standard
Indivo and SMARTWhat Indivo adds to SMART
• Rich write capability
• Consumer-facing features including authentication, carenets/sharing, and auditing
• Consumer-facing data-types which are not yet ratified as part of the SMART model
• Indivo apps can be either purely SMART-compliant or take advantage of hybrid functionality, with graceful degredation to SMART compliance in non-Indivo containers
Indivo iOS
framework
• Handles authentication (OAuth)
• Provides Indivo objects (automatic XML handling)
• Knows where an object comes from (REST paths)
• Provides messaging functionality
Makes your life easy™
The iOS Framework
Abstract logic into Cocoa objects
Server Record
addDocumentOfClass:
fetchReportsOfClass:
selectRecord:
Docspush:
replace:
archive:
...
Basic Approach
Setup
App Flow
#define kIndivoFrameworkServerURL @“http://10.17.20.127:8000”#define kIndivoFrameworkUIServerURL @“http://10.17.20.127:8001”
#define kIndivoFrameworkAppId @“[email protected]”#define kIndivoFrameworkConsumerKey @“nkd8cg02mgo34sntkao9”#define kIndivoFrameworkConsumerSecret @“1acgk9804wkmraoceu02”
server = [IndivoServer serverWithDelegate:self];
Logging in
App Flow
[server selectRecord:^{ }];
server.activeRecord
Adding a medication
App Flow
Medication *med = [record addDocument:Medication];
[med push:^{ }];
med.drugName = [INCodedValue new];
med.drugName.title = @“Tylenol”;
med.drugName.system ...
Sending a message
App Flow
[med.activeRecord sendMessage:@“New medication added”
withBody:@“See medlist app”
ofType:INMessageTypePlaintext
severity:INMessageSeverityMedium
attachments:nil
callback:^{ }];
Documentation
• Take a look at README.md
• Checkout the sample medication app
• Technical documentation available online:
• http://docs.indivohealth.org/projects/indivo-x-ios-framework/en/latest/
Playing with Medications
Portal-PCHR Hybrid• SMART Platform Apps
Have access to EHR data in a vendor agnostic fashion (from an Epic system, a Cerner system, or an complementary system with data warehoused from the EHR)
• So, one can readily create a patient facing portal, which is an apps platform
SMART
EHREHR
SMART
IndivoIndivoConnector App
Connector App
Clinician-Facing Apps
Clinician-Facing Apps
Patient-Facing Apps
Patient-Facing Apps
The best of both worlds: •A local portal, with lots of data from the EHR•A personal health platform with patient control, sharing, and apps
Portal-PCHR Hybrid
The Challenge:
“Build an Indivo app that provides value to patients using data delivered through the
SMART API and its Indivo-specific extensions”
•These should be patient facing web or mobile apps, and run against the Indivo Developer Sandbox•They should be of importance to clinical medicine or public health•Examples include: a medication manager, a health risk detector, a patient-friendly laboratory visualization tool, or an app that integrates external data sources with patient records in real time.
Resources
•Indivo:
•http://indivohealth.org/smart-indivo-app-challenge
•http://docs.indivohealth.org
•http://sandbox.indivohealth.org
•https://github.com/chb/IndivoFramework-ios
•http://www.youtube.com/watch?v=qNWujzx46bI
•SMART
•http://smartplatforms.org
Judging Criteria
1. Usefulness to patients
2. Importance to clinical medicine or public health
3. Interface and presentation
4. Use of the Indivo and SMART APIs
5. Creative use of data from the sandbox and (optionally) from open health data sources
Timeline
Submission Period EndsSeptember 28, 2012
Winner NotifiedOctober 18, 2012
